Built On Bad Advice – Why So Many Med Spas Are Failing

Provider-based healthcare is a unique business. As an owner/operator, you've likely invested thousands of hours in clinical education and hands-on patient care. But in that same journey, you've probably had little to no training in business management, finance, HR, marketing, or leadership. And yet, you're expected to make major decisions about LLCs, financial statements, loans, equipment purchases, and business expansion.

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The aesthetics space continues to grow rapidly. Patient demand is up, demographics are expanding, and new med spas are opening every week. Riding alongside this growth is a surge of Key Opinion Leaders (KOLs) in the industry. Charismatic, well-connected, and often center-stage at industry conferences, these individuals talk about best practices, products, and why you should open your next location. They command attention. But should they command your trust?

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Trust is everything, and too often, that trust is placed in the wrong people—advisors with no real-world experience owning or running a provider-based business. In many cases, practice owners make major strategic decisions based on the advice of individuals who have never provided patient care or built a sustainable practice themselves. That kind of blind trust can shape the next 5 to 10 years of your business—and not always for the better.

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Over the past year, the U.S. aesthetics market has seen a notable number of business failures. According to the Bureau of Labor Statistics, 45% of new businesses fail within five years. Aesthetics is proving to be no exception. We’ve had countless conversations with large-scale buyers who echo the same sentiment: premium opportunities are drying up, and distressed practices—many plagued by financial mismanagement—are growing more common. At TUSK, we regularly speak with practice owners looking to sell, only to realize that their businesses aren’t financially healthy enough to secure a valuable exit. Many can’t even pay off the debt leveraged against the business. These are heartbreaking conversations, and in most cases, entirely avoidable.

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So, who do you trust? Here are three questions every medical aesthetics practice owner should ask when choosing advisors—whether it’s a CPA, attorney, broker, consultant, or marketing firm:

1. Have they done this before? Not just worked in business services generally—but have they specifically worked in provider-based healthcare? Are they experienced across multiple healthcare verticals like dermatology, dentistry, or med spa? Or are they opportunists who jumped into aesthetics because they saw a market opening? Be cautious of those who only operate in aesthetics. Often, they were simply first to market or they paid for exposure—not necessarily the most qualified.

2. What’s their motivation? Motivation drives behavior. Many KOLs and advisors present as thought leaders, but are ultimately pushing a product, a rebrand, a legal service, or a consulting package. Their advice may not be aligned with your best interests. Ask yourself: what do they gain from the advice they’re giving? Are they helping you build your business—or helping themselves grow theirs?

3. Jack of all trades or master of one? Avoid one-stop shops and clear conflicts of interest. The attorney who gives financial advice, the broker who also buys practices, or the marketing firm that doubles as a consultant—these are red flags. Depth matters. When you’re investing your time, money, and life’s work into a business, you want best-in-class guidance at every stage, not someone who does a little bit of everything. Someone who lives and breathes their niche. The industry is littered with so-called “experts” who spread themselves thin across too many domains. Don’t be fooled. Ask the tough questions. Make sure their expertise runs deep—not just wide—and that their goals are directly aligned with yours.

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The medical aesthetics industry has an exciting future, but only for those who make strategic, well-advised decisions. Partnering with the wrong people can slow your growth, destroy your margins, and ultimately leave you with a business that isn’t built to sell—or even survive. Finding the right people takes work, but it’s a crucial investment in your long-term success.

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At TUSK Practice Sales, we work exclusively with healthcare practice owners who want to maximize the value of their business and exit on their terms. We’re not generalists. We don’t offer bolt-on services. We don’t play both sides of the table. We represent sellers—and only sellers. We know how to evaluate your practice through the eyes of sophisticated buyers, avoid the common pitfalls, and build a roadmap to a successful transaction.

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In a crowded industry full of noise, trust matters more than ever. Make sure yours is well-placed.

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